WHAT TO DO WITH LIMITED VIEW - THE INTUMESCENT CATARACT

In 1991, 2,967 consecutive cataract cases were analyzed in a prospecti ve, observational study for the incidence of intumescent cataract. Thi rty four (1.15%) of the cases were mature intumescent lenses. A delibe rately small continuous curvilinear capsulorhexis (CCC) enlarged secon darily by the two-stage continuous curvilinear capsulorhexis (2-CCC) t echnique was the anterior capsulotomy approach of choice. Depending on the liquidity of the lens material, liquid cortex was aspirated using a 26- or 30-gauge needle before capsulorhexis or through a small CCC. Because of loss of CCC control, a can-opener capsulotomy was used in three of the 34 cases before being converted by the 2-CCC technique. T he rigid nucleus was usually extracted using the down-slope nucleofrac tis phacoemulsification technique. Four (11.7%) of the 34 intumescent cases had anterior capsule tears during capsulotomy. Successful in-the -bag lens implantation was achieved in all cases. We describe a techni que of CCC, 2-CCC, and down-slope sculpting nucleofractis phacoemulsif ication to manage intumescent cataracts.